This is probably the most important article I've ever read in the mainstream media about weight maintenance. It finally acknowledges the role of biohormones in weight maintenance and the fact that the metabolisms of those who have lost more than 10% of their body weights are slowed by 15 - 20% as compared to a never-obese/overweight person. We've been talking about it here in the Maintainers forum for the past few years, but it never seems to be discussed anywhere else.

I'm not sure the link will work because it's a subscription site. Let me know if you can't access it.

I have to quote the last paragraph of the article:

Quote:

How do some people manage to overcome the leptin effect and keep weight off? Generally by watching their food intake very carefully and continuing to increase their physical activity. "Anybody who has lost weight and kept it off will tell you that they have to keep battling," says Dr. Rosenbaum. "They have essentially reinvented themselves, and they are worthy of the utmost admiration and respect."

That, in a nutshell, is what the Maintainers Forum is all about. Don't wait until you reach goal -- come check us out now.

So, you ate less and exercised more and lost weight. But now the pounds are piling back on. You're hungrier than ever, and you can't seem to resist food. Once again, it's all your fault, right?

Wrong. Blame evolution, and the fact that for the vast majority of human history, famine was a bigger threat than flab. Even your seeming lack of will power is part of a complex biological system that drives humans who have lost weight to regain it, according to new brain-scan research by scientists at Columbia University Medical Center.

"Loosely put, after you've lost weight, you have more of an emotional response to food and less ability to control that response," says Michael Rosenbaum, lead author of the study in this month's Journal of Clinical Investigation.

The key driver of this system is leptin, a hormone secreted by fat cells. When humans (and rodents) lose 10&#37; or more of their body weight, leptin falls rapidly and sets off a cascade of physiological changes that act to put weight back on. Skeletal muscles work more efficiently, thyroid and other hormones are reduced -- all so the body burns 15% to 20% fewer calories, enough to put back 25 pounds or more a year.

This mechanism kicks in whether people are obese or relatively lean before losing weight -- and researchers believe the effect can last for years. In previous studies, giving subjects replacement leptin reversed the metabolic changes, in effect tricking the body into ignoring the weight loss.

The latest study shows that these metabolic changes are mirrored in altered brain activity when people lose weight. The Columbia researchers put six obese subjects on liquid diets and reduced their weight by 10%, then gave them replacement leptin or a placebo. At each stage, researchers observed their brain activity using functional MRIs when they were shown food and non-food items.

The scans showed that in the weight-reduced state, the subjects had more blood flow in areas of the brain that govern emotional and sensory responses to food and less in areas involving control of food intake. When the subjects were given replacement leptin, brain activity returned to what it had been before they lost weight.

There are still many unknowns about how blood flow in the brain corresponds to behavior. "I can't look at these scans and say, in 30 seconds, you're going to eat a banana," says Rudolph Leibel, a co-author of the Columbia study who helped discover leptin in the 1990s at Rockefeller University. Still, he says, the brain images provide further evidence of the powerful biological forces that send humans into survival mode, mentally and physically, when food is scarce and fat stores decline. "These people act as if they are hungrier, and combined with reduced energy expenditure, that's the 'perfect storm' for gaining weight."

Dr. Leibel also says that people should understand that regaining lost weight "is not free will. It's biologically determined and the species that didn't have this are the ones you see in the Museum of Natural History." It's only been in recent decades that this mechanism is contributing more to obesity than survival. "Now, anyone can summon an unlimited amount of food just with a cellphone," he says.

Scientists originally thought leptin might be harnessed as a weight-loss drug. Amylin Pharmaceuticals Inc. continues to research that possibility and is in Phase 2 trials of a combination of leptin and pramlintide, a diabetes drug. But leptin may hold more promise in helping to keep weight off, an area that the Columbia researchers say deserves more attention.

How do some people manage to overcome the leptin effect and keep weight off? Generally by watching their food intake very carefully and continuing to increase their physical activity. "Anybody who has lost weight and kept it off will tell you that they have to keep battling," says Dr. Rosenbaum. "They have essentially reinvented themselves, and they are worthy of the utmost admiration and respect."

The book "You on a Diet" talks about leptin, and tells you to eat something with fat just before your meal (because it takes about 20 minutes), because that stimulates leptin and the feeling of fullness.

That makes me wonder if the studies address that - in other words, if the effect they saw is primarily due to the emphasis on low fat diets that reigned for so long. I know one study they mentioned had to do with a liquid diet, which I wouldn't think would be very leptin-stimulating. I wonder how much the effects in that study can be ameliorated by using fats well.

__________________ Started 4/14/08 LINK TO PROGRESS PICS 1/1/2009 "It is impossible to live pleasurably without living wisely, well, and justly, and it is impossible to live wisely, well, and justly without living pleasurably" Epicurus

Hi Julie! From everything that I've read about leptin, the lowered leptin levels we have after weight loss aren't the result of the kind of diet we used to lose the weight. Rather it's the body's response to a loss of more than 10&#37; of its weight by whatever means and is designed to preserve the status quo. Our bodies will fight hard to stay at their setpoints (discussed more in Gina Kolata's Rethinking Thin).

I've never heard that nuts or fats increase leptin levels before so that's interesting information. Clinical trials have been going on for quite some time investigating supplemental leptin for weight loss maintenance and I've even checked to see if I'm eligible (I'm not, unfortunately). Wouldn't it be great if we could get the same effect from eating nuts!

Interesting. I've taken fish oil capsules for the past three years and still have to keep my calories to 1400/day, with 90+ minutes of exercise, in order to maintain my weight loss. So it seems that even with the fish oil, my metabolism is slower than "normal" since calculators indicate that I should be able to eat well over 2000 calories at my activity level and still maintain.

But that's just ancedotal evidence, of course! It's great that research is finally focusing on weight loss maintenance and maybe we'll get answers soon that can actually help us.

Meg,
Thanks for posting that. I am very interested in the research that is coming out. Especially as it validates the lived experience of so many of us. The hormone influence is interesting but I agree so much that the paragraph you highlighted above is really *my* bottom line.

The one about reinventing ourselves.

Cause leptins and hormones and fat cells aside (and yes, each of those may increase our struggles to maintain), it is about a new relationship with food and movement that can never stop.

While reading it, I was strongly reminded of the first time I lost a significant amount of weight.

I lost probably 60-70 pounds (not sure, since I was too scared to weigh myself when I started), and got down to about 183 pounds. I was the slimmest I'd ever been as an adult, I lost the bowling pin look, and I looked almost like I did in the first few years of high school.

But, I couldn't hold on to it. I remember mindlessly looking through cubbards in the kitchen for anything and everything to stuff in my face, even though I wasn't hungry. I remember silently screaming "STOP! STOP! What are you doing?!!! You don't want to go back to how you were before!!"

I remember being appalled, and even panicked, at what I was doing but I just couldn't seem to stop. It was almost like I was an observer at those times, unable to control myself as I ransacked the refrigerator. And sure enough, I gained the weight back.

It's interesting to know that there is probably a biological reason that it happened, and it wasn't just a lack of will power. I feel like less of a failure now.

It's probably also worth mentioning that a lifetime of ignoring the effects of leptin (i.e. that feeling of satiation) can contribute to leptin resistance. The body of a very overweight or obese person will not respond to or be able to produce leptin in some cases.

Interesting article. I'm no where near the maintainer stage yet but I work the graveyard shift and have read lots about how sleep deprivation lowers leptin which is one reason shiftworkers tend to have a lot more trouble losing weight. Or keeping weight off.

Meg, about those fish oil capsules. The fish oil has to be fresh. Break a capsule open and put a couple drops on your tongue. If it tingles then it's gone bad. Fish oil in a bottle from the refrigerated section is better and buy a small bottle you'll use up in a month. Always take it with food, too.

__________________

"Vision without action is a daydream ~ Action without vision is a nightmare"

Thanks for posting the article Meg. Other research I have read supports it. I definitely think the last paragraph sums up maintenance!

As far as nuts helping. I have recently added more walnuts and ground flax to my diet. It does seem to be helping me in maintenance mode. I prefer adding these to taking fish oil for two reasons.
1 - as a vegetarian, I am trying to find non-animal sources
2 - I try to get as many essential nutrients as I can from food, rather than supplements. I believe that many nutrients are more beneficial when combined with other ingredients in their natural form. I think science is a long way from knowing exactly how complex the whole concept is.

__________________Do you not know that your body is a temple of the Holy Spirit within you, which you have from God, and that you are not your own?ICor 6:19My Pictorial Journey" "My Goal Story